| 1. |
- Gillberg, Christopher, 1950, et al.
(författare)
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Mortality in autism: a prospective longitudinal community-based study.
- 2010
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Ingår i: Journal of Autism and Developmental Disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 40:3, s. 352-357
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Tidskriftsartikel (refereegranskat)abstract
- The purposes of the present study were to establish the mortality rate in a representative group of individuals (n = 120) born in the years 1962-1984, diagnosed with autism/atypical autism in childhood and followed up at young adult age (>/=18 years of age), and examine the risk factors and causes of death. The study group, which constituted a total population sample of children with these diagnoses, were followed up in Swedish registers. Nine (7.5%) of the 120 individuals with autism had died at the time of follow-up, a rate 5.6 times higher than expected. The mortality rate was significantly higher among the females. Associated medical disorders (including epilepsy with cognitive impairment) and accidents accounted for most of the deaths, and it was not possible to determine whether autism "per se" actually carries an increased mortality risk.
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| 2. |
- Lernfelt, Gustaf, et al.
(författare)
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Atrial fibrillation in the elderly general population: a 30-year follow-up from 70 to 100 years of age
- 2020
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 54:4, s. 232-8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. There is limited knowledge of atrial fibrillation (AF) incidence among the very old. Data from longitudinal cohort studies may give us a better insight. The aim of the study was to investigate the incidence rate and prevalence of AF, as well as the impact of AF on mortality, in the general population, from 70 to 100 years of age. Design. This was a population-based prospective cohort study where three representative samples of 70-year-old men and women (n = 2,629) from the Gerontological and Geriatric Populations Studies in Gothenburg (H-70) were included between 1971 and 1982. The participants were examined at age 70 years and were re-examined repeatedly until 100 years of age. AF was diagnosed according to a 12-lead electrocardiogram (ECG) recording at baseline and follow-up examinations, from the Swedish National Patient Register (NPR), or from the Cause of Death Register. Results. The cumulative incidence of AF from 70 to 100 years of age was 65.6% for men and 52.8% for women. Mortality was significantly higher in participants with AF compared with those without, rate ratio (RR) 1.92 (95% CI 1.73-2.14). In a subgroup analysis comprising only participants with AF diagnosed by ECG at screening, the RR for death was 1.29 (95% C.I: 1.03-1.63). Conclusions. Among persons surviving to age 70, the cumulative incidence of AF was over 50% during follow-up. Mortality rate was twice as high in participants with AF compared to participants without AF. Among participants with AF first recorded at a screening examination, the increased risk was only 29%.
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| 3. |
- Lewerin, Catharina, 1961, et al.
(författare)
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Low holotranscobalamin and cobalamins predict incident fractures in elderly men: the MrOS Sweden.
- 2014
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Ingår i: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 25:1, s. 131-140
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Tidskriftsartikel (refereegranskat)abstract
- In a population-based study on cobalamin status and incident fractures in elderly men (n=790) with an average follow-up of 5.9years, we found that low levels of metabolically active and total cobalamins predict incident fractures, independently of body mass index (BMI), bone mineral density (BMD), plasma total homocysteine (tHcy), and cystatin C.
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| 4. |
- Lewerin, Catharina, 1961, et al.
(författare)
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Serum estradiol associates with blood hemoglobin in elderly men; The MrOS Sweden Study
- 2014
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 99:7, s. 2549-56
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Tidskriftsartikel (refereegranskat)abstract
- Context: Blood hemoglobin (Hb) declines with age in healthy elderly men, in whom decreasing testosterone has been regarded as part of normal ageing. However, the association between Hb and serum estradiol is incompletely known. Objective: To determine whether estradiol is associated with anemia/Hb and established determinants of Hb in elderly men without prostate cancer. Design, Setting and Participants: The MrOS (Osteoporotic Fractures in Men) is a population-based study (n=918, median age 75.3 years, range 70-81 years). Main Outcome Measures: We evaluated total estradiol in relation to Hb and adjusted for potential confounders (i.e. age, body mass index (BMI), erythropoietin (EPO), total testosterone, cystatin C, iron- and B-vitamin status). Results: Estradiol correlated negatively with age (r=-0.14, p<0.001). Hb correlated (age adjusted) positively with estradiol (r=0.21, p<0.001) and testosterone (r=0.10, p<0.01). Independent predictors for Hb in multivariate analyses were estradiol, EPO, BMI, transferrin saturation, cystatin C and free T4 but not testosterone. After exclusion of subjects with Hb <130g/L and/or testosterone <8 nmol/L (n=99), the correlation between Hb and testosterone was no longer significant, whereas the associations between Hb and estradiol remained. After adjusting for age, BMI and EPO, men with lower estradiol levels were more likely to have Hb in the lowest quartile of values [OR per SD decrease in estradiol = 1.61 (95% CI 1.34-1.93)]. Anemic subjects (Hb <130 g/L) had lower mean estradiol than non-anemic (67.4 vs 79.4 pmol/L, p<0.001). Conclusions: Estradiol correlated, positively and independently, with Hb. Decreased estradiol might partly explain the age-related Hb decline observed in healthy elderly men.
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| 5. |
- Rödström, Kerstin, 1953, et al.
(författare)
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A longitudinal study of the treatment of hot flushes: the population study of women in Gothenburg during a quarter of a century
- 2002
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Ingår i: Menopause. - 1072-3714. ; 9:3, s. 156-161
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Sahlgrenska/Akademin, Sahlgrenska University Hospital, Göteborg University, Sweden. Kerstin.Rodstrom@allmed.gu.se OBJECTIVE: To describe the prevalence and treatment of hot flushes in premenopausal and postmenopausal women from the 1960s to the 1990s. DESIGN: This prospective study, based on a random sample of the total female population of 430,000 in Gothenburg, Sweden, was started in 1968, with follow-ups in 1974, 1980, and 1992. The participants were 1,462 women born in 1930, 1922, 1918, 1914, and 1908 (participation rate 90.1%) who were representative of women of the same age in the general population. For the purpose of analyzing secular trends, we included 122 participants who were 38 years old and 47 who were 50 years old in 1980-1981. RESULTS: The prevalence of hot flushes increased from approximately 11% at 38 years to a maximal prevalence of approximately 60% at 52 to 54 years of age, then declined successively from approximately 30% at 60 years of age to approximately 15% at 66 years of age, and then to approximately 9% at 72 years of age. The predominant type of medication being prescribed changed during the observation period from sedatives/anticholinergic drugs in the 1960s to hormone replacement therapy in the 1980s. Hormone replacement therapy was considered to be an effective form of treatment for hot flushes by 70% to 87% of the women. CONCLUSIONS: Hot flushes were a common symptom, with a maximal prevalence of 64% at 54 years of age. Medical consultation and treatment did not increase in 50-year-old women from 1968-1969 to 1980-1981. Treatment changed and became more effective during the observation period. PMID: 11973438 [PubMed - indexed for MEDLINE]
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| 6. |
- Rödström, Kerstin, 1953, et al.
(författare)
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Evidence for a secular trend in menopausal age: a population study of women in Gothenburg
- 2003
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Ingår i: Menopause. ; 10 (6):Nov-Dec, s. 538-543
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Sweden. Kerstin.Rodstrom@allmed.gu.se OBJECTIVE: To describe secular trends in age of natural menopause. DESIGN: A prospective study based on a random sample of the total female population in Gothenburg, Sweden, started in 1968 with follow-ups in 1974-75, 1980-81, 1992-93, and 2000-02. Participants: 1,462 women born in 1930, 1922, 1918, 1914, and 1908 (participation rate, 90.1%) representative of women of the same ages in the general population. Information regarding menopausal age was provided by 1,373 of the 1,462 women (93.9%). The number was further reduced to 1,017 after exclusion of women who had taken hormones, undergone a surgical menopause, or both. RESULTS: The mean age at natural menopause showed a steady increase across birth cohorts. Trends were similar in women who had smoked and women who had never smoked, even after adjusting for different covariates. The upward trend was 0.1 years per birth year (SE 0.020, P < 0.0001). Interestingly, women with earlier menarche had a somewhat earlier age at menopause, independent of the cohort effect. When hormone users were included in the sample, the cohort effect was also found to be independent of oral contraceptive use and hormone therapy. CONCLUSIONS: This study has shown that, independent of variations in socioeconomic status, smoking status, oral contraceptive use, or hormone therapy use, as well as other potential confounders, there was a highly significant secular trend of increase in menopausal age. The observation of a positive association between menarche and menopausal age has, to our knowledge, not previously been described. PMID: 14627863 [PubMed - indexed for MEDLINE]
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| 7. |
- Silveira, Ellen R. T., 1963, et al.
(författare)
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Performance of the SF-36 health survey in screening for depressive and anxiety disorders in an elderly female Swedish population.
- 2005
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Ingår i: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. - : Springer Science and Business Media LLC. - 0962-9343. ; 14:5, s. 1263-74
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the sensitivity, specificity and predictive validity of suggested cut-off scores in the SF-36 mental health (MH) and mental component summary (MCS) in screening for depressive and anxiety disorders in a population sample of older Swedish women. METHOD: The sample comprised 586 randomly selected females aged 70-84 years who took part in an in-depth psychiatric examination. This provided the 'gold standard' against which the usefulness of SF-36 recommended thresholds for screening for depressive and anxiety disorders in older Swedish women was examined. RESULTS: Based on DSM-III-R criteria, 69 women (12%) were diagnosed with depression (major depression, dysthymia and/or depression NOS) and 49 (8%) with generalised anxiety and panic disorders. The previously recommended MH and MCS cut-offs (i.e. 52 and 42) gave a specificity for diagnosis of depression of 92 and 82% and sensitivity of 58 and 71%, respectively. Both the MH and MCS were good predictors of depressive disorders but poor predictors of anxiety disorders. CONCLUSION: The study supports the predictive validity of suggested SF-36 MH and MCS cut-off scores in screening for depressive disorder but not for anxiety disorder in older women in Sweden.
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| 8. |
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| 9. |
- Wentz, Elisabet, 1964, et al.
(författare)
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Bone density 11 years after anorexia nervosa onset in a controlled study of 39 cases.
- 2003
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Ingår i: International Journal of Eating Disorders. - 0276-3478. ; 34:3, s. 314-318
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate bone mineral density (BMD) and body composition 11 years after the onset of anorexia nervosa (AN). Method Thirty-nine AN subjects (36 females, 3 males), selected from a population-based sample, and 46 matched controls (COMP; 43 females, 3 males) were examined by using double-energy X-ray absorptiometry (DXA). Only 2 women still had AN. None of the men had AN. Results The females in the AN and COMP groups did not differ regarding BMD, nor was there a difference across female groups concerning body mass index (BMI). The female AN group had a significantly lower percentage of body fat. BMD among females in the AN group was related to lowest BMI ever. There was an inverse relationship between lumbar BMD and AN duration. Discussion Low BMD is not overrepresented among weight-restored AN patients at long-term follow-up compared with healthy women. However, the inverse relationship between BMD and AN duration may be indicative of a risk for osteopenia in patients with subchronic and chronic AN.
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| 10. |
- Andersson, Christina, 1955, et al.
(författare)
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Drinking context and problematic alcohol consumption in young Swedish women : Drinking context and problematic alcohol consumption
- 2013
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Ingår i: Addiction Research and Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 21:6, s. 457-468
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has indicated that a variety of contextual factors are involved in the development of drinking behavior. An integrated perspective can extend our understanding of the context and circumstances in which individuals drink. In this study, a person-oriented approach, cluster analysis, was used to identify drinking context clusters in a population of 20- and 25-year-old Swedish women. A further aim was to analyze how these clusters were associated with problematic alcohol consumption (high episodic drinking (HED) and alcohol use disorder (AUD)). A total of 760 respondents were interviewed, some in 1996 and some in 2001. Self-reported effects of drinking and situational factors associated with drinking alcohol were used in the cluster analysis procedure. Logistic regression models were used to analyze the associations with problematic alcohol consumption. The results revealed four distinct clusters of drinking patterns: coping drinkers, social drinkers, controlled drinkers, and moderate drinkers. Differences between clusters concerning problematic alcohol consumption were found. HED was significantly more common among the social drinkers and alcohol use disorder was more prevalent among the coping drinkers. Age differences and to a lesser extent secular trends in drinking pattern could be observed. The findings suggest that information on drinking context can help to explain differences in patterns of risky drinking and AUD. This highlights the importance of identifying groups of individuals with potentially harmful drinking patterns, which could be the target of specific preventive actions.
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| 11. |
- Andersson, Christina, 1955, et al.
(författare)
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Dryckeskontextens betydelse för unga kvinnors alkoholkonsumtion. En klusteranalys av 20- och 25-åriga kvinnor åren 1995 och 2000.
- 2008
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Ingår i: Läkarstämman, Göteborg 2008.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Dryckeskontextens betydelse för unga kvinnors alkoholkonsumtion. En klusteranalys av 20- och 25-åriga kvinnor åren 1995 och 2000. Bakgrund Under de senaste åren har framför allt en del internationell drogforskning fokuserat på fenomen som dryckeskontext och egna motiv till att dricka samt dessas samband med alkoholkonsumtion. Dryckeskontext har i nämnda studier definierats på något olika sätt, några mer teoretiskt förankrade, gemensamt kan sägas att man försökt besvara frågor om var, med vem och varför man druckit alkohol I den aktuella studien har vi analyserat sambandet mellan dryckeskontext och alkoholkonsumtion bland 20- och 25-åriga kvinnor i Göteborg. Syftet var att undersöka om det fanns specifika dryckesmönster, med hänsyftning på kontextuella variabler, om dessa dryckesmönster skiljde sig åt mellan undersökningsåren och om vissa dryckesmönster visade starkare samband med olika grader av alkoholkonsumtion. Metod Data från en befolkningsundersökning, ”Kvinnor och alkohol i Göteborg”: I studien ingick 897 unga kvinnor intervjuade under åren 1995 och 2000. Då dryckeskontext kan ses som ett multifaktoriellt fenomen valde vi att använda klusteranalys (”Two-step clustering”) för att identifiera grupper med olika dryckesmönster. Vi använde Pearson Chi-square för att undersöka skillnader i alkoholkonsumtion mellan de olika grupperna. Alkoholkonsumtion fördelades som Alkoholmissbruk/beroende - ABM, Intensivkonsumtion (60g etanol/tillfälle) - IK, Intensivkonsumtion/12 mån. – IK12 och Hög alkoholkonsumtion (20g etanol/dag senaste månaden) - HAK. Resultat Med hjälp av klusteranalys identifierades tre grupper med olika dryckesmönster för varje undersökningsår. 1995 syntes en grupp måttlighetsdrickare, en grupp som drack ofta både i sociala sammanhang och i ensamhet samt en grupp som bejakade mest upplevda effekter av sitt drickande. 2000 fann vi åter gruppen måttlighetsdrickare, därtill en grupp där man bejakade sociala effekter av alkohol och en annan grupp som uppgav mer fysiska och kognitiva effekter. 1995 visade gruppen som drack i ofta i sociala sammanhang signifikanta samband med ABM, IK12 och HAK. År 2000 sågs signifikanta samband med alla konsumtionsvariablerna hos de båda grupper som bejakande olika upplevda effekter av alkoholanvändning. Sammanfattning Klusteranalys var en god metod för att identifiera grupper med olika dryckesmönster som underlag för analys av skillnader i alkoholkonsumtion. Analysen understryker vikten av att ta hänsyn till upplevda effekter av och egna anledningar till drickande när man vill medverka till en minskad alkoholkonsumtion i befolkningen.
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| 12. |
- Andersson, Christina, 1955, et al.
(författare)
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Women's patterns of everyday occupations and alcohol consumption : Everyday occupations and alcohol consumption
- 2012
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 19:3, s. 225-238
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Tidskriftsartikel (refereegranskat)abstract
- Earlier studies on women's health and drinking and the contemporary associated risk factors, have highlighted the need for more complex approaches in understanding the pathways into women's problem drinking. Research, from both social science and from occupational therapy models, has underlined the importance of deconstructing the often dichotomized way of investigating women's daily lives (such as in paid and unpaid work or in work and leisure) when discussing factors from the daily life environment and their impact on health issues. The aim of this study was to explore the relationship between women's patterns of everyday occupation and alcohol consumption using the broader concept of occupation from occupational therapy models. This was a cross-sectional study from the latest wave (2000) of a population-based project, Women and Alcohol in Gothenburg (WAG). The study group consisted of 851 women, aged 20-55 years. Using an individually oriented method, two-step clustering, three distinct patterns of everyday occupations were identified. Significant associations with problematic alcohol consumption were found in the clusters, characterized by lower engagement in leisure activities and a larger amount of spare time. The need for new preventive approaches, including investigating the importance of having engaging leisure activities, is discussed.
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| 13. |
- Andersson, Christina, 1955, et al.
(författare)
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Young women´s drinking contexts. A cluster analysis of 20- and 25-year old women.
- 2007
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Ingår i: 33rd Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society, Budapest 20070604-08.
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Konferensbidrag (refereegranskat)abstract
- During the last years some international research on young adult drinking have focused on drinking contexts and drinking motives and the association with alcohol consumption. In this study we have analysed the association between drinking context and alcohol consumption in 20- and 25-year old women in Sweden. The aim was to find if drinking patterns, with respect to drinking context, varied between 1995 and 2000 and if specific drinking patterns related to specific consumption variables. Method: A total of 897 respondents were interviewed in 1995 and 2000. Looking at drinking context as a multi-dimensional phenomenon we chose two-step clustering as a method for identifying the drinking patterns. We used Pearson Chi-square to test for differences between the cluster groups with respect to problematic alcohol consumption. Results: Three clusters of drinking patterns in 1995 and 2000 respectively were defined. In 1995 the clusters were characterised as moderate drinking, partying and solitary drinking and drinking effects. In 2000 the three cluster groups were moderate drinking, social effects-drinking and individual effects and solitary drinking. Association with alcohol consumption showed significant differences: in 1995 the cluster party and solitary drinking was related to alcohol use disorders, binge drinking and high alcohol consumption, in 2000 the two clusters including drinking effects showed associations with all consumption variables.
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| 14. |
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| 15. |
- André, Malin, et al.
(författare)
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Cohort differences in personality in middle-aged women during a 36-year period. Results from the Population Study of Women in Gothenburg
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:5, s. 457-464
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate secular trends in personality traits in adult female populations. METHODS: Two representative, population-based cohorts of women, 38 (n = 318) and 50 (n = 593) years of age participated in a health examination in 1968 and 2004 in Gothenburg, Sweden. The Eysenck Personality Inventory (EPI) and Cesarec-Marke Personality Schedule (CMPS) were used to measure personality traits. Socioeconomic and lifestyle variables (personal income, education, marital status, children at home, physical activity and smoking) were reported. RESULTS: In both age groups, secular comparisons in psychological profile subscales showed an increase in dominance, exhibition, aggression and achievement. Only small divergences were seen concerning affiliation, guilt feelings, nurturance and succorance. EPI showed a corresponding rise in extroversion. Social data showed a statistically significant increase in percentage of unmarried women, personal income levels, and higher educational achievement. While around 70% of women in 1968-69 had elementary school education only, around 90% had high school or university education in 2004-05. CONCLUSIONS: The results indicate major transitions in the adult Swedish female population in the direction of a more stereotypically ''male'' personality profile, but not at the expense of traditionally socially important female traits, which remained constant. These results are consistent with the hypothesis that society and the environment influence personality.
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| 16. |
- André, Malin, et al.
(författare)
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Personality in women and associations with mortality: a 40-year follow-up in the Population Study of Women in Gothenburg
- 2014
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 14:61
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Tidskriftsartikel (refereegranskat)abstract
- Background: The question of whether personality traits influence health has long been a focus for research and discussion. Therefore, this study was undertaken to examine possible associations between personality traits and mortality in women. Methods: A population-based sample of women aged 38, 46, 50 and 54 years at initial examination in 1968-69 was followed over the course of 40 years. At baseline, 589 women completed the Cesarec-Marke Personality Schedule (the Swedish version of the Edwards Personal Preference Schedule) and the Eysenck Personality Inventory. Associations between personality traits and mortality were tested using Cox proportional hazards models. Results: No linear associations between personality traits or factor indices and mortality were found. When comparing the lowest (Q1) and highest quartile (Q4) against the two middle quartiles (Q2 + Q3), the personality trait Succorance Q1 versus Q2 + Q3 showed hazard ratio (HR) = 1.37 (confidence interval (CI) = 1.08-1.74), and for the factor index Aggressive non-conformance, both the lowest and highest quartiles had a significantly higher risk of death compared to Q2 + Q3: for Q1 HR = 1.32 (CI = 1.03-1.68) and for Q4 HR = 1.36 (CI = 1.06-1.77). Neither Neuroticism nor Extraversion predicted total mortality. Conclusions: Personality traits did not influence long term mortality in this population sample of women followed for 40 years from mid- to late life. One explanation may be that personality in women becomes more circumscribed due to the social constraints generated by the role of women in society.
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| 17. |
- Arnoldussen, I. A. C., et al.
(författare)
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A 10-Year Follow-Up of Adiposity and Dementia in Swedish Adults Aged 70 Years and Older
- 2018
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Ingår i: Journal of Alzheimers Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 63:4, s. 1325-1335
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adiposity measured in mid-or late-life and estimated using anthropometric measures such as body mass index (BMI) and waist-to-hip ratio (WHR), or metabolic markers such as blood leptin and adiponectin levels, is associated with late-onset dementia risk. However, during later life, this association may reverse and aging- and dementia-related processes may differentially affect adiposity measures. Objective: We explored associations of concurrent BMI, WHR, and blood leptin and high molecular weight adiponectin levels with dementia occurrence. Methods: 924 Swedish community-dwelling elderly without dementia, aged 70 years and older, systematically-sampled by birth day and birth year population-based in the Gothenburg city region of Sweden. The Gothenburg Birth Cohort Studies are designed for evaluating risk and protective factors for dementia. All dementias diagnosed after age 70 for 10 years were identified. Multivariable logistic regression models were used to predict dementia occurrence between 2000-2005, 2005-2010, and 2000-2010 after excluding prevalent baseline (year 2000) dementias. Baseline levels of BMI, WHR, leptin, and adiponectin were used. Results: Within 5 years of baseline, low BMI (<20 kg/m(2)) was associated with higher odds of dementia compared to those in the healthy BMI category (>= 20-24.9 kg/m(2)). Compared to the lowest quartile, leptin levels in the second quartile were associated with lower odds of dementia in women (p < 0.05). Conclusion: In late-life, anthropometric and metabolic adiposity measures appear to be differentially associated with dementia risk. While BMI and leptin levels are highly positively correlated, our results show that their association with dementia at age >= 70 years, is asynchronous. These data suggest that with aging, the complexity of the adiposity exposure may increase and suggests metabolic dysregulation. Additional studies are needed to better understand this complexity.
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| 18. |
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| 19. |
- Bergdahl, Ingvar A., et al.
(författare)
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Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women.
- 2013
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 86:1, s. 71-7
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Purpose Markers of mercury (Hg) exposure have shown both positive and negative associations with cardiovascular disease (CVD). We assessed the association between serum Hg (S–Hg) and risk of cardiovascular disease in a prospective population-based cohort, with attention to the roles of dental health and Wsh consumption. Methods Total mortality, as well as morbidity and mortality from acute myocardial infarction (AMI) and stroke, was followed up for 32 years in 1,391 women (initially age 38–60), in relation to S–Hg at baseline, using Cox regression models. Potential confounders (age, socioeconomic status, serum lipids, alcohol consumption, dental health, smoking, hypertension, waist-hip ratio, and diabetes) and other covariates (e.g., Wsh consumption) were also considered. Results Hazard ratios (HR) adjusted only for age showed strong inverse associations between baseline S–Hg and total mortality [highest quartile: hazard ratio (HR) 0.76; 95% conWdence interval (CI) 0.59–0.97], incident AMI (HR 0.56; CI 0.34–0.93), and fatal AMI (HR 0.31; CI 0.15–0.66). Adjustment for potential confounding factors, especially dental health, had a strong impact on the risk estimates, and after adjustment, only the reduced risk of fatal AMI remained statistically signiWcant. Conclusions There was a strong inverse association between Hg exposure and CVD. Likely, reasons are confounding with good dental health (also correlated with the number of amalgam Wllings in these age groups) and/or Wsh consumption. The results suggest potential eVects of dental health and/or Wsh consumption on CVD that deserve attention in preventive medicine.
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| 20. |
- Björkelund, Cecilia, 1948, et al.
(författare)
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Secular trends in cardiovascular risk factors with a 36-year perspective: observations from 38- and 50-year-olds in the Population Study of women in Gothenburg
- 2008
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 26:3, s. 140-6
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Tidskriftsartikel (refereegranskat)abstract
- Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg, Sweden. cecilia.bjorkelund@allmed.gu.se OBJECTIVES: To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. DESIGN: Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. SETTING: Gothenburg, Sweden with approximately 450,000 inhabitants. SUBJECTS: Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). MAIN OUTCOME MEASURES: Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. RESULTS: There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. CONCLUSIONS: Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.
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| 21. |
- Blomstrand, Ann, et al.
(författare)
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Forty-four-year longitudinal study of stroke incidence and risk factors - the Prospective Population Study of Women in Gothenburg
- 2022
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 40:1, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Objective To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors. Design Prospective population study. Setting Gothenburg, Sweden, with similar to 450,000 inhabitants. Subjects A representative sample of a general population of women (1462 in total) in 5 age strata aged 38-60 years in 1968-1969 (the Population Study of Women in Gothenburg, PSWG) were followed up to the ages of 82-104 years in 2012. Further, analysis was also performed for the age interval 60-82 years. Main outcome measures Incidence of total stroke (TS), ischaemic (IS), haemorrhagic (HS), non-specified (NS) and fatal (FS) strokes and association with baseline classic risk factors (such as hypertension, atrial fibrillation, low physical activity, diabetes, high waist-hip-ratio, hyperlipidaemia, smoking), low education, mental stress, pre-eclampsia and oral health as expressed by loss of teeth and bone score. Blood pressure in levels 1-3 according to modern guidelines. Associations with atrial fibrillation, diabetes and myocardial infarction shown in survival analyses. The five cohorts contributed to risk time data concerning associations with TS in the 60-82 age interval from the examination performed when they were 60. Results Three hundred and thirty-seven (23%) women had a first-ever stroke, 64 (19%) fatal. TS was associated with physical inactivity, high triglycerides and low education in multivariable analysis. The main sub-type IS was associated with systolic blood pressure, physical inactivity and low education. Pre-eclampsia showed association with IS only in the univariable analysis. FS was associated with systolic blood pressure and smoking. During 60-82 years of age, having <20 teeth (HR 1.74, CI 1.25-2.42), diabetes (HR 2.28 CI 1.09-4.76), WHR (HR 1.29 per 0.1 units CI 1.01-1.63), systolic blood pressure (HR 1.11 per 10 units CI 1.04-1.18) and smoking (HR 1.57, CI 1.14-2.16), were associated with TS in the combined five cohorts. Conclusions Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.
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| 22. |
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| 23. |
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| 24. |
- Eiben, Gabriele, 1960, et al.
(författare)
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Secular trends in diet among elderly Swedes - cohort comparisons over three decades
- 2004
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Ingår i: Public Health Nutrition. ; 7:5, s. 637-644
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Box 454, SE-405 30 Göteborg, Sweden. gabriele.eiben@medfak.gu.se OBJECTIVE: The purpose of this study was to compare dietary practices among different birth cohorts of 70-year-old Swedes, who were examined between 1971 and 2000. SETTING: Göteborg, Sweden. DESIGN: Four population-based samples of 1360 70-year-olds, born in 1901, 1911, 1922 and 1930, have undergone health examinations and dietary assessments over a period of almost three decades. One-hour diet history (DH) interviews were conducted in 1971, 1981, 1992 and 2000 with a total of 758 women and 602 women. The formats and contents of the dietary examinations were similar over the years. Statistical analysis of linear trends was conducted, using year of examination as the independent variable, to detect secular trends in food and nutrient intakes across cohorts. RESULTS: At the 2000 examination, the majority of 70-year-olds consumed nutritionally adequate diets. Later-born cohorts consumed more yoghurt, breakfast cereals, fruit, vegetables, chicken, rice and pasta than earlier-born cohorts. Consumption of low-fat spread and milk also increased, along with that of wine, light beer and candy. In contrast, potatoes, cakes and sugar were consumed less in 2000 than in 1971. The ratio of reported energy intake to estimated basal metabolic rate did not show any systematic trend over time in women, but showed a significant upward trend in men. CONCLUSIONS: The diet history method has captured changes in food selections in the elderly without changing in general format over three decades. Dietary quality has improved in a number of ways, and these findings in the elderly are consistent with national food consumption trends in the general population. PMID: 15251054 [PubMed - indexed for MEDLINE]
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| 25. |
- Eriksson, Bo G., 1944, et al.
(författare)
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Cross-cultural analysis of longevity among Swedish and American elders: the role of social networks in the Gothenburg and Missouri longitudinal studies compared
- 1999
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Ingår i: Archives of Gerontology and Geriatrics. - 0167-4943. ; 28:2, s. 131-148
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports the results of a cross-national comparison of the 'H70' longitudinal study of elders in Gothenburg, Sweden, with the 'Rural Missouri Elders' longitudinal study in Missouri, USA. Analysis of the combined data sets focused on the question of how longevity was affected by culturally divergent forms of social network participation. The H70 study was a representative, systematic 3/10 sample of 70-year-old (in 1971) men and women living in Gothenburg. Follow-up data was gathered when the respondents were 75, 79, 81, 82, 83, 85, 88, 90 and 95 years of age. Face-to-face interviews and physical medical examinations were the major source of data. The Missouri study involved a representative cluster proportional- to-size sample of all rural Missourians 65 years of age and older. Face-to-face interviews were conducted in 1966, 1974 and 1987. Logistic regression and cross-tabular analyses revealed that social networks were important predictors of longevity for both samples. However, marital status and participation in formal organizations predicted longevity for the Americans, whereas contact with children emerged as the predictor variable for the Swedes. Specific functions of the different network patterns in the two countries are discussed.
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| 26. |
- Eriksson, Bo G., 1944, et al.
(författare)
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Prediction of seven-year survival by artificial neural network and logistic regression: A comparison of results from medical and social data among 70-year-olds in Göteborg, Sweden.
- 2010
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Ingår i: Department of Sociology, University of Gothenburg.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Problem: Are there, for practical uses, any benefits of Artificial Neural Network analyses (ANN) compared with logistic regression analyses? Data: A random sample of 2,294 70-year-old persons from Göteborg, Sweden, was investigated through interviews and medical examinations. Methods: Seven-year mortality was studied by neural network analysis using the SPSS module Clementine 9.0 and by standard logistic regression analysis. The guiding problem was as follows: How do examples of ANN analyses perform compared with logistic regression models in the analyses of one set of social variables and one set of biological and health variables from the same individuals? Result: The ANN generally did not perform better than logistic regression analyses, but in the data set with biological and health predictors, some ANN analyses produced much better results than logistic regression models when odds ratios were compared. Discussion and Conclusion: The ANN can be used as a heuristic method to evaluate if there are hidden structures in data that are not revealed by regression methods and thus call for further analyses, either by more adequate regression models or by other methods. The ANN models could be used as predictors of outcomes of multifactor genesis, which has not been well understood using other investigation methods.
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| 27. |
- Garemo, Malin, 1971, et al.
(författare)
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Serum phospholipid fatty acids are associated with bone mass in healthy 4-years-old children.
- 2024
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Ingår i: Prostaglandins, leukotrienes, and essential fatty acids. - 1532-2823. ; 200
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Tidskriftsartikel (refereegranskat)abstract
- Fatty acids are involved in bone development but knowledge in children is limited. The aim of this study was to investigate bone mass and mineral density in healthy preschool children in relation to fatty acids.In 111 healthy 4-yrs-old children (20% overweight) bone was analysed by dual X-ray absorptiometry and serum phospholipid fatty acid by gas chromatography. Fat intake was calculated from 7 days self-reported dietary records and food frequency questionnaire.Total bone mass content (BMC) and mineral density (BMD) differed by sex in normal weight, but not in overweight children showing generally higher bone mass density than children with normal weight. Linoleic acid intake was strongly correlated to BMC and femoral BMD in normal weight children. Serum concentration of docosahexaenoic acid correlated positively to BMD in all children (p=0.01), but linoleic and arachidonic acids, and monounsaturated fatty acids showed diverging associations with bone in normal weight and overweight children.Serum phospholipid DHA was associated with bone density. Other fatty acids associations to bone sites differed in overweight children, analogue to the pattern in healthy 8-yrs-old.The finding need to be confirmed longitudinally and in a larger group of overweight individuals.
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| 28. |
- Grimby, Agneta, et al.
(författare)
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Walking habits in elderly widows.
- 2008
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Ingår i: The American journal of hospice & palliative care. - : SAGE Publications. - 1049-9091 .- 1938-2715. ; 25:2, s. 81-7
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Tidskriftsartikel (refereegranskat)abstract
- Walking habits were studied in 3 groups of elderly widows. The average walking time per week was calculated from interviews or questionnaires. There was in a small studied group a tendency for walking time to be lower at 3 and 12 months after loss than at 4 or 5 years. An increased odds ratio was demonstrated in larger groups of widows for walking less than 120 minutes per week in those who "did not feel healthy," or who had "musculoskeletal health problems," or "cardiovascular health problems." Widows from a population-based study also showed increased odds ratio for not walking as long with "lack of friends" and "not being active in associations." This was not found in married women from the population study. Our results indicate that newly bereaved women may reduce their physical activity, and that the change in exercise habits may be associated with reduced perception of being healthy and a decreased social network.
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| 29. |
- Gustafson, Deborah, 1966, et al.
(författare)
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The ACE Insertion Deletion polymorphism relates to dementia by metabolic phenotype, APOEepsilon4, and age of dementia onset.
- 2010
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Ingår i: Neurobiology of aging. - : Elsevier BV. - 1558-1497 .- 0197-4580. ; 31:6, s. 910-6
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Tidskriftsartikel (refereegranskat)abstract
- The renin-angiotensin system (RAS) may play a role in dementia pathogenesis because of its effects on vascular and metabolic homeostasis, amyloid metabolism, and learning and memory. The angiotensin-converting enzyme (ACE), a pivotal RAS protein, is encoded for by a gene containing a functional ID variant, which has been related to dementia risk. We examined the relationship between the ACE Insertion Deletion (ACE ID) variant and dementia with consideration for metabolic phenotypes, age and APOEepsilon4 using a population-based, cross-sectional sample of 891 Swedish women and men aged 70-92 years, of whom 61 people were demented. The odds of dementia was two-fold higher among those with ACE II genotype, and ranged from 2.18 to 4.35 among those with dementia onset
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| 30. |
- Haghsheno, Mohammad-Ali, et al.
(författare)
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Low 25-OH Vitamin D Level is Associated with Benign Prostatic Enlargement (BPE).
- 2013
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Ingår i: The Journal of urology. - : Ovid Technologies (Wolters Kluwer Health). - 1527-3792 .- 0022-5347. ; 190:2, s. 608-614
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To test the hypothesis that low levels of vitamin D were associated with Benign Prostatic Enlargement (BPE). We also studied whether body composition, sex hormones, serum SHBG, albumin corrected serum calcium, adiponectin and lipid statuses were associated with BPE. MATERIALS AND METHODS: 184 representative randomly selected men aged 72 - 76 years, enrolled in the Gothenburg arm of the MrOs study, were investigated. Men with a medical history of prostate cancer, prostate operation or medication for BPE were excluded leaving 155 men to be analyzed. A cross-sectional study was conducted in which BPE, as measured by the total prostate gland volume, was related to clinical, anthropometric, endocrine and metabolic factors, using univariate and multivariate analyses with regression models. RESULTS: The median prostate volume was 40 ml. In multivariate models only 25-OH vitamin D, albumin corrected serum calcium, serum SHBG and HDL-cholesterol were significantly and inversely associated with large prostate glands. CONCLUSION: The present report adds four independent factors associated with BPE: Low levels of 25-OH vitamin D, serum calcium, SHBG and HDL-cholesterol.
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| 31. |
- Haghsheno, Mohammad-Ali, et al.
(författare)
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Lower urinary tract symptoms are associated with low levels of serum serotonin, high levels of adiponectin and fasting glucose, and benign prostatic enlargement.
- 2015
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Ingår i: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1813 .- 2168-1805. ; 49:2, s. 155-161
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. The aim of this study was to test whether lower urinary tract symptoms (LUTS) and urinary incontinence are associated with the metabolic syndrome (MetS). The association between LUTS and benign prostatic enlargement (BPE) was also investigated. Material and methods. A cross-sectional, representative risk factor analysis of LUTS, as measured by the International Prostate Symptom Score (IPSS), and urinary incontinence was conducted. Among 950 representative individuals, aged 69-81 years, the association between clinical, anthropometric, endocrine, metabolic and inflammatory factors on the one hand, as both major and minor aspects of MetS, and LUTS and urinary incontinence, on the other hand, was analysed. The prostate gland volume was measured in a subgroup of 155 randomly selected individuals and the association between LUTS and BPE was estimated. Results. No significant association was found between LUTS or urinary incontinence and the major aspects of the MetS. However, in a multivariate analysis, serum serotonin showed an independent negative correlation with LUTS and with urinary incontinence while fasting serum glucose and serum adiponectin showed a positive correlation with LUTS. Furthermore, in a subgroup of 155 individuals, the prostate gland volume correlated positively with LUTS. Conclusions. The study did not show an association between LUTS or urinary incontinence and the major components of the MetS. However, serum serotonin showed an independent negative correlation with LUTS and with urinary incontinence while fasting serum glucose and serum adiponectin showed a positive correlation with LUTS. The data confirm the general knowledge that BPE may be one of the causative factors of LUTS.
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| 32. |
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| 33. |
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| 34. |
- Hange, Dominique, 1963, et al.
(författare)
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Perceived nervousness and moodiness associated with increased CVD but not cancer morbidity in pre- and postmenopausal women. Observations from the Population Study of Women in Gothenburg, Sweden
- 2009
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Ingår i: International Journal of General Medicine. - 1178-7074. ; 2, s. 39-45
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: A 32-year prospective observational study was initiated in 1968, including 1462 women aged 60, 54, 50, 46, and 38, representative of the female population in these age groups. Measures included self-reported nervous symptoms and moodiness at baseline, menopausal status, risk factors as smoking, s-cholesterol, s-triglycerides, body mass index (BMI), waist–hip ratio (WHR), blood pressure, and socioeconomic status (SES). The prevalence of nervousness and moodiness was investigated as well as if these reported symptoms could predict mortality and morbidity within 32 years in pre-and postmenopausal women. Women who reported at least two of the symptoms suffered from an increased risk of 32-year mortality, independent of all background variables described above (hazard ratio [HR] = 1.28, confidence interval [CI] 1.03–1.58). Women with only one of the nervous symptoms already had an increased risk of suffering from cardiovascular disease (CVD) also after multivariable adjustment (HR = 1.29, CI 1.09–1.52) a risk that also remained significant when analyzing CVD risk in the group of premenopausal women (HR = 1.28, CI 1.02–1.62). There was no significantly increased risk among pre-or postmenopausal women with perceived nervousness/moodiness of developing cancer during the 32-year follow-up. There seems to be an association between nervousness/moodiness and premature mortality and morbidity in CVD, especially when present already in the premenopausal state in women.
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| 35. |
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| 36. |
- Hange, Dominique, 1963, et al.
(författare)
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The natural history of psychosomatic symptoms and their association with psychological symptoms: observations from the Population Study of Women in Gothenburg.
- 2007
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Ingår i: The European journal of general practice. - : Informa UK Limited. - 1381-4788 .- 1751-1402. ; 13:2, s. 60-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the prevalence of subjective unspecified psychological symptoms (UPS) in a cohort of middle-aged women and the development of psychosomatic symptoms over 24 years. METHODS: In 1968-1969, 1462 randomly selected women, aged 38, 46, 50, 54 and 60, were recruited. A 24-year follow-up was performed in 1992-1993 (n=836). The same structured interview concerning psychological and psychosomatic symptoms was used on both occasions. RESULTS: The prevalence of UPS was 28% in 1968-1969 and 20% in 1992-1993. Women with UPS in 1968-1969 were significantly more likely to have asthma/obstructive symptoms (34% vs 26%), headache (38% vs 22%) and abdominal symptoms (40% vs 21%), but not hypertension/high blood pressure (28% vs 28%), than women who did not report UPS. In 1992-1993, women with UPS in 1968-1969 were significantly still more likely to have asthmatic (25% vs 18%) and abdominal symptoms (44% vs 33%). Sixty-one per cent of women with UPS in 1968-1969 did not report such symptoms in 1992-1993, compared to 86% of women without UPS in 1968-1969 (p<0.001). CONCLUSION: Women reporting UPS seemed to have a higher frequency of simultaneous psychosomatic symptoms than women not reporting UPS. However, having UPS was apparently unassociated with the development of psychosomatic symptoms over time. Psychosomatic symptoms in women seem to be self-limiting and decrease with time.
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| 37. |
- Hessler, Richard, et al.
(författare)
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The compression of morbidity debate in aging: an empirical test using the gerontological and geriatric population studies in Göteborg, Sweden (H70)
- 2003
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Ingår i: Archives of Gerontology and Geriatrics. ; 37:3, s. 213-222
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Tidskriftsartikel (refereegranskat)abstract
- The H70 longitudinal study of aging, Göteborg, Sweden is used to empirically test the compression of morbidity theory advanced by [Fries, 1980 and Fries and Crapo, 1981]. We reconceptualize compression as postponement of morbidity in the sense of decreasing amounts of illness for increasingly long life spans. Operationally, morbidity is defined as the average number of hospital days in the last year of life. The date of death and the date of 1-year prior to death define the risk period. The linear regression model with age at death, age at death squared, year of birth, and sex are statistically significant with the oldest having the fewest hospital days. The findings offer partial support for the compression of morbidity theory.
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| 38. |
- Himmelmann, Kate, 1959, et al.
(författare)
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Survival with cerebral palsy over five decades in western Sweden
- 2015
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Ingår i: Developmental medicine and child neurology. - : Wiley. - 1469-8749 .- 0012-1622. ; 57:8, s. 762-767
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Tidskriftsartikel (refereegranskat)abstract
- The life expectancy of individuals with cerebral palsy (CP) is often reduced compared with the general population. Long-term survival with CP is rarely reported. The aim of this study was to investigate survival and the causes of death in relation to CP type and motor and accompanying impairments documented in the CP register of western Sweden over five decades.
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| 39. |
- Johansson, Åsa K, 1971, et al.
(författare)
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Anticipatory grief among close relatives of persons with dementia in comparison with close relatives of patients with cancer
- 2013
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Ingår i: American Journal of Hospice and Palliative Medicine. - : SAGE Publications. - 1049-9091 .- 1938-2715. ; 30:1, s. 29-34
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Tidskriftsartikel (refereegranskat)abstract
- Close relatives of persons with dementia self-reported reactions on the Anticipatory Grief Scale (AGS), were observed by nurses (Study I), and compared with relatives of cancer patients in a study using the same methodology (Study II). Study I showed an overall stressful situation including feelings of missing and longing, inability to accept the terminal fact, preoccupation with the ill, tearfulness, sleeping problems, anger, loneliness, and a need to talk. The ability to cope was, however, reported high. Selfassessments and nurses’ observations did not always converge, e.g. for the acceptance of the illness. The reactions of the relatives in the dementia and the cancer groups showed more similarities than dissimilarities. However, the higher number of responding spouses in the cancer group may have influenced the outcome.
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| 40. |
- Jonasson, Grethe, 1945, et al.
(författare)
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A prospective study of mandibular trabecular bone to predict fracture incidence in women: A low-cost screening tool in the dental clinic
- 2011
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Ingår i: Bone. - : Elsevier BV. - 8756-3282. ; 49:4, s. 873-879
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Tidskriftsartikel (refereegranskat)abstract
- Bone structure is the key to the understanding of fracture risk. The hypothesis tested in this prospective study is that dense mandibular trabeculation predicts low fracture risk, whereas sparse trabeculation is predictive of high fracture risk. Out of 731 women from the Prospective Population Study of Women in Gothenburg with dental examinations at baseline 1968, 222 had their first fracture in the follow-up period until 2006. Mandibular trabeculation was defined as dense, mixed dense plus sparse, and sparse based on panoramic radiographs from 1968 and/or 1980. Time to fracture was ascertained and used as the dependent variable in three Cox proportional hazards regression analyses. The first analysis covered 12 years of follow-up with self-reported endpoints; the second covered 26 years of follow-up with hospital verified endpoints; and the third combined the two follow-up periods, totaling 38 years. Mandibular trabeculation was the main independent variable predicting incident fractures, with age, physical activity, alcohol consumption and body mass index as covariates. The Kaplan–Meier curve indicated a graded association between trabecular density and fracture risk. During the whole period covered, the hazard ratio of future fracture for sparse trabeculation compared to mixed trabeculation was 2.9 (95% CI: 2.2–3.8, p < 0.0001), and for dense versus mixed trabeculation was 0.21 (95% CI: 0.1–0.4, p < 0.0001). The trabecular pattern was a highly significant predictor of future fracture risk. Our findings imply that dentists, using ordinary dental radiographs, can identify women at high risk for future fractures at 38–54 years of age, often long before the first fracture occurs.
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| 41. |
- Jonasson, Grethe, 1945, et al.
(författare)
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Evaluation of clinical and radiographic indices as predictors of osteoporotic fractures: a 10-year longitudinal study.
- 2018
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Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier BV. - 2212-4411 .- 2212-4403. ; 125:5, s. 487-494
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to evaluate 2 radiographic and 3 clinical indices as predictors of future osteoporotic fractures.In a prospective, longitudinal study with a 10-year fracture follow-up, the 2 radiographic indices mandibular cortical erosion (normal, mild/moderate erosion, and severe erosion of the inferior cortex) and cortex thickness were assessed using panoramic radiographs of 411 women, age 62 to 78 years. The clinical indices were the fracture assessment tool FRAX, the osteoporosis index of risk (OSIRIS), and the osteoporosis self-assessment tool (OST).The relative risks (RRs) for future fracture were significant for FRAX greater than 15%, 4.1 (95% confidence interval [CI] 2.4-7.2), and for severely eroded cortices, 1.7 (95% CI 1.1-2.8). Cortical thickness less than 3mm, OSIRIS, and OST were not significant fracture predictors (RR 1.1, 1.4, and 1.5, respectively). For the 5 tested fracture predictors, Fisher's exact test gave the following P values for differences between fracture and nonfracture groups: FRAX <.001, cortical erosion 0.023, OST 0.078, OSIRIS 0.206, and cortical thickness 0.678. The area under the curve was 0.69 for FRAX less than 15%, 0.58 for cortical erosion, and 0.52 for cortical thickness. Adding OSIRIS and OST did not change the area under the curve significantly.FRAX and severely eroded cortices predicted fracture but cortical thickness, OSIRIS, and OST did not.
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| 42. |
- Jonasson, Grethe, 1945, et al.
(författare)
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Mandibular bone changes in 24years and skeletal fracture prediction.
- 2013
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Ingår i: Clinical Oral Investigations. - : Springer Science and Business Media LLC. - 1432-6981 .- 1436-3771. ; 17:2, s. 565-572
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objectives of the investigation were to describe changes in mandibular bone structure with aging and to compare the usefulness of cortical and trabecular bone for fracture prediction. MATERIALS AND METHODS: From 1968 to 1993, 1,003 women were examined. With the help of panoramic radiographs, cortex thickness was measured and cortex was categorized as: normal, moderately, or severely eroded. The trabeculation was assessed as sparse, mixed, or dense. RESULTS: Visually, the mandibular compact and trabecular bone transformed gradually during the 24years. The compact bone became more porous, the intertrabecular spaces increased, and the radiographic image of the trabeculae seemed less mineralized. Cortex thickness increased up to the age of 50 and decreased significantly thereafter. At all examinations, the sparse trabeculation group had more fractures (71-78%) than the non-sparse group (27-31%), whereas the severely eroded compact group showed more fractures than the less eroded groups only in 1992/1993, 24years later. Sparse trabecular pattern was associated with future fractures both in perimenopausal and older women (relative risk (RR), 1.47-4.37) and cortical erosion in older women (RR, 1.35-1.55). RR for future fracture associated with a severely eroded cortex increased to 4.98 for cohort 1930 in 1992/1993. RR for future fracture associated with sparse trabeculation increased to 11.43 for cohort 1922 in 1992/1993. CONCLUSION: Dental radiographs contain enough information to identify women most at risk of future fracture. CLINICAL RELEVANCE: When observing sparse mandibular trabeculation, dentists can identify 40-69% of women at risk for future fractures, depending on participant age at examination.
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| 43. |
- Klingberg, Sofia, 1979, et al.
(författare)
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Lower risk of hip fractures among Swedish women with large hips?
- 2018
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 29:4, s. 927-935
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Tidskriftsartikel (refereegranskat)abstract
- In women, a large hip circumference (HC) related to lower hip fracture risk, independent of age and regardless if HC was measured long before or closer to the fracture. In older women, body mass index (BMI) explained the protection. In postmenopausal women, HC has been suggested to inversely associate with hip fracture while this has not been investigated in middle-aged women. We examined the association between HC, measured at two different time points, and hip fracture in a Swedish female population-based sample monitored for incident hip fractures over many years. Baseline HC, measured in 1968 or 1974 (n = 1451, mean age 47.6 years), or the HC measures that were the most proximal before event or censoring (n = 1325, mean age 71.7 years), were used to assess the effects of HC on hip fracture risk in women participating in the Prospective Population Study of Women in Gothenburg. HC was parameterized as quintiles with the lowest quintile (Q1) as reference. Incident hip fractures over 45 years of follow-up (n = 257) were identified through hospital registers. Higher quintiles of HC at both baseline and proximal to event were inversely associated with hip fracture risk in age-adjusted models, but only baseline HC predicted hip fractures independently of BMI and other covariates (HR (95% CI) Q2, 0.85 (0.56-1.27); Q3, 0.59 (0.36-0.96); Q4, 0.57 (0.34-0.96); Q5, 0.58 (0.31-1.10)). A large HC is protective against hip fracture in midlife and in advanced age, but the association between proximal HC and hip fracture was explained by concurrent BMI suggesting that padding was not the main mechanism for the association. The independent protection seen in middle-aged women points to other mechanisms influencing bone strength.
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| 44. |
- Kristjansson, Karl, 1958, et al.
(författare)
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Blood pressure and pulse pressure development in a population sample of women with special reference to basal body mass and distribution of body fat and their changes during 24 years
- 2003
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Ingår i: International Journal of Obesity. ; 27, s. 128-133
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Tidskriftsartikel (refereegranskat)abstract
- Department of Family Medicine, Solvangur Health Centre, University of Iceland, Hafnarfjördur, Iceland. karlk@hgsolvangur.is OBJECTIVE: To study blood pressure and pulse pressure longitudinally and their association with basal and change of body mass index (BMI) and waist to hip ratio (WHR). DESIGN: A prospective population study of 1462 women in Gothenburg, Sweden, aged 38-60 y at baseline, with a longitudinal follow-up of 24 y. OUTCOME MEASURES: Incidence of hypertension, systolic and diastolic blood pressure, and pulse pressure at baseline and after 12 and 24 y of follow-up. RESULTS: Systolic and diastolic blood pressure as well as pulse pressure increased with age and turned down again at high age. BMI and WHR at baseline were each independently associated with baseline systolic and diastolic blood pressure, but only BMI with pulse pressure. However, baseline BMI and WHR were not associated with change of systolic, diastolic or pulse pressure during 12 or 24 y of follow-up. Increase in BMI during the follow-up period was associated with increase in systolic and diastolic blood pressure but not with increase in pulse pressure. There were no such associations with WHR changes which, were either unrelated or in one analysis inversely related with blood pressure changes. When considering incidence of hypertension during the first 12 y of follow-up, BMI and change in BMI were significant predictors, independent of WHR. CONCLUSION: Age, BMI and increments in BMI seem to be strong predictors for hypertension and increased systolic and diastolic blood pressure in women. In contrast, WHR plays a lesser and uncertain role in the development of hypertension in middle-aged women. Changes in BMI seem not to be accompanied by changes in pulse pressure during a long time follow-up. PMID: 12532164 [PubMed - indexed for MEDLINE]
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| 45. |
- Leu Agelii, Monica, 1977, et al.
(författare)
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Low vitamin D status in relation to cardiovascular disease and mortality in Swedish women - Effect of extended follow-up
- 2017
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Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 0939-4753 .- 1590-3729. ; 27:12, s. 1143-1151
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: The impact of vitamin D concentrations on subsequent cardiovascular disease (CVD) and overall mortality has been generally examined for periods under two decades. The magnitude of the association may depend on follow-up length. We aimed to investigate the relationship between baseline vitamin D and risk of total CVD, stroke and all-cause mortality over three decades of follow-up. Secondly, we aimed to assess how follow-up affects the associations. Methods and results: Concentrations of 25-hydroxyvitamin D (25D) were measured in a population-based sample of 1227 middle-aged women using serum collected at baseline and categorized into low (lowest 25D quartile) vs high 25D status (upper three 25D quartiles). Hazard ratio (HR) of the endpoints was estimated for low 25D. The impact of follow-up was examined in intermediary analyses where follow-up was interrupted up to four times, each time decreasing it by five years. There were 596 cardiovascular events and 635 participants died. During the first 17 years, the low 25D group experienced a 29% higher CVD risk and 3.3-fold higher stroke risk after accounting for confounders. Longer follow-up diminished significantly these risks and 25D status had no contribution at 32 years. For mortality, the decline over time was less dramatic, with HR = 1.96 (1.25; 3.08) at 17 years and HR = 1.42 (1.17; 1.72) at 37 years. Conclusion: Low 25D status increased the risk for all endpoints, but a lengthy follow-up diminished these risks towards the null. The impact of follow-up depends on the outcome. Future studies of 25D and disease should use repeated 25D assessments. (C) 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B. V. All rights reserved.
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| 46. |
- Lindqvist, Peter, 1945, et al.
(författare)
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Concurrent and separate effects of body mass index and waist-to-hip ratio on 24-year mortality in the Population Study of Women in Gothenburg: evidence of age-dependency
- 2006
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Ingår i: European Journal of Epidemiology. ; 21, s. 789-794
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Tidskriftsartikel (refereegranskat)abstract
- Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy at Göteborg University, P.O. Box 454, SE 405 30, Göteborg, Sweden. peter.lindqvist@allmed.gu.se Obesity is generally assumed to be an important risk factor for death and morbidity. However, the association between excess body weight and all-cause mortality among younger and older women and the impact of body mass index (BMI) and waist-to-hip ratio (WHR) concurrently is not fully understood. In 1968-1969 we initiated a prospective study comprising a population sample of 1,462 women from Gothenburg, Sweden. During a 24 year period, until 1992-1993, 265 women had died. A multivariable Cox Proportional Hazards Regression model was used to estimate the relative risk of death in relation to BMI and WHR, with age and other covariates of age-specific interest as smoking, physical activity at work and leisure time and serum triglyceride concentration, at start of the study. BMI and WHR were analyzed as independent variables. Younger women (38 and 46 years at baseline) presented a statistically significant non-linear (U-shaped) relation between BMI and mortality. Among older women (50, 54 and 60 years at baseline), a significant negative linear relationship with decreasing mortality in relation to increasing BMI values was seen. For all women a higher WHR was related to an increased risk of death. The lowest risk of death among younger women corresponded to a low WHR and a BMI within the middle range. For older women the highest survival was observed for those with lowest WHR and highest BMI. Thus, in older women a high BMI seems not to be an increased risk as long as adiposity is not centrally located. PMID: 17111249 [PubMed - indexed for MEDLINE]
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| 47. |
- Lissner, Lauren, 1956, et al.
(författare)
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Participation bias in longitudinal studies: experience from the Population Study of Women in Gothenburg, Sweden
- 2003
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Ingår i: Scandinavian Journal of Primary Health Care. ; 21, s. 242-247
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. lauren.lissner@medfak.gu.se OBJECTIVE: To describe a cohort study of women receiving a series of comprehensive health examinations over 32 years. DESIGN: Longitudinal population study based on a randomised sample of the female population from defined age cohorts. SETTING: City of Göteborg, Sweden. SUBJECTS: Subjects were 38, 46, 50, 54 or 60 years old at the start of the study in 1968. Re-examinations were performed in 1974, 1982 and 1992. Non-participants in the most recent examination, initiated in 2000, were offered home visits. MAIN OUTCOME MEASURES: Participation, anthropometric and blood pressure changes. RESULTS: At the end of the 32-year follow-up, 64% of the original participants were alive, and low participation among survivors was a problem. An acceptable participation rate (71% of those alive) was obtained after home visits were offered. Surviving non-participants already had elevated cardiovascular risk factors at onset of the study in 1968, along with lower educational level and lower socioeconomic status. Home visited subjects were similar to non-participants with regard to anthropometry and blood pressure, but did not differ from participants with regard to social indicators. Thirty-two-year longitudinal data demonstrate clear ageing effects for several important variables, which should, however, be considered in the context of documented differences with non-participants at the baseline examination. CONCLUSIONS: Longitudinal studies in elderly populations provide important data on changes during the ageing process. However, participation rates decline for a number of reasons and generalisations should be made with care. Moreover, including home visits in the protocol can both increase participation and reduce participation bias in elderly cohorts. PMID: 14695076 [PubMed - indexed for MEDLINE]
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| 48. |
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| 49. |
- Najar, Jenna, et al.
(författare)
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Cognitive and physical activity and dementia A 44-year longitudinal population study of women
- 2019
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 92:12
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether cognitive and physical activities in midlife are associated with reduced risk of dementia and dementia subtypes in women followed for 44 years. Methods A population-based sample of 800 women aged 38-54 years (mean age 47 years) was followed from 1968 to 2012. Cognitive (artistic, intellectual, manual, religious, and club) and physical activity were assessed at baseline. During follow-up, dementia (n = 194), Alzheimer disease (n = 102), vascular dementia (n = 27), mixed dementia (n = 41), and dementia with cerebrovascular disease (n = 81) were diagnosed according to established criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. Cox regression models were used with adjustment for age, education, socioeconomic status, hypertension, body mass index, cigarette smoking, diabetes mellitus, angina pectoris, stress, and major depression. Results We found that cognitive activity in midlife was associated with a reduced risk of total dementia (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.49-0.89) and Alzheimer disease (HR 0.54; 95% CI 0.36-0.82) during follow-up. Physical activity in midlife was associated with a reduced risk of mixed dementia (HR 0.43; 95% CI 0.22-0.86) and dementia with cerebrovascular disease (HR 0.47; 95% CI 0.28-0.78). The results were similar after excluding those who developed dementia before 1990 (n = 21), except that physical activity was then also associated with reduced risk of total dementia (HR 0.67; 95% CI 0.46-0.99). Conclusion Our findings suggests that midlife cognitive and physical activities are independently associated with reduced risk of dementia and dementia subtypes. The results indicate that these midlife activities may have a role in preserving cognitive health in old age.
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| 50. |
- Natarajan Gavriilidou, Nivetha, et al.
(författare)
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Does mandibular bone structure predict subsequent height loss? A longitudinal cohort study of women in Gothenburg, Sweden.
- 2023
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Ingår i: BMJ open. - : BMJ Publishing Group. - 2044-6055. ; 13:7
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Tidskriftsartikel (refereegranskat)abstract
- Several risk factors for loss of height with increasing age have been identified.To investigate if mandibular bone structure predicts future height loss in middle-aged and elderly Swedish women.Prospective cohort study with longitudinally measured heights, radiographical assessments of the cortical bone using Klemetti's Index (normal, moderate or severely eroded cortex) and classification of the trabecular bone using an index proposed by Lindh et al (sparse, mixed or dense trabeculation). No intervention was performed.Gothenburg, Sweden.A population-based sample of 937 Swedish women born in 1914, 1922 and 1930 was recruited. At the baseline examination, the ages were 38, 46 and 54 years. All had undergone a dental examination with panoramic radiographs of the mandible, and a general examination including height measurements on at least two occasions.Height loss was calculated over three periods 12-13years (1968-1980, 1980-1992, 1992-2005).Mean annual height loss measures were 0.075cm/year, 0.08cm/year and 0.18cm/year over the three observation intervals, corresponding to absolute decreases of 0.9cm, 1.0cm and 2.4cm. Cortical erosion in 1968, 1980 and 1992 significantly predicted height loss 12 years later. Sparse trabeculation in 1968, 1980 and 1992 also predicted significant shrinkage over 12 or 13 years. Multivariable regression analyses adjusting for baseline covariates such as height, birth year, physical activity, smoking, body mass index and education yielded consistent findings except for cortical erosion 1968-1980.Mandibular bone structure characteristics such as severe cortical erosion and sparse trabeculation may serve as early risk factors for height loss. Since most individuals visit their dentist at least every 2years and radiographs are taken, a collaboration between dentists and physicians may open opportunities for predicting future risk of height loss.
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